Avaliação do perfil de citocinas inflamatórias e do nível de atividade física em pacientes com doença de Crohn antes e após terapia com infliximabe

Abstract

Patients with Crohn's disease (CD) have a lower level of physical activity (PA), and this behavior is determined in part by disease activity. Infliximab (IFX) therapy may induce clinical remission and, therefore, promote increased PA activity. However, the predictive factors of improvement of PA after clinical remission in CD are elusive. Therefore, we aimed to evaluate the profile of inflammatory cytokines and the possible increase of PA in patients with CD treated with IFX. In the cohort of 44 patients with CD who started treatment with IFX, 38 (86.4%) achieved clinical remission at the 24th week of treatment. Demographics, clinical, anthropometric, exercise capacity, muscle strength, PA level and serum levels of TNF-α (tumor necrosis factor alpha), IL-6 (interleukin), IL-17 and IFN-ɣ (interferon gamma) were evaluated at baseline and at week 24 in patients with and without improvement in PA level. Demographic, clinical and anthropometric data were similar in patients with and without improvement in the level of PA. All patients responding to IFX at the 24th week (n = 38 / 86.4%) presented a significant decrease in the cytokines evaluated. In the group without remission to IFX, a significant increase of IL-6 and IL-17 was observed in patients with increasing number of steps/day (NS/day), and elevation of IL-6, IL-17 and TNF-α in patients who increased your active time, measured by the accelerometer. Patients who did not respond to IFX, who did not show improvement in the NS/day, had only TNF-α increase. In conclusion, in patients with active CD in IFX-induced remission, the serum levels of IL-6, IL-17, TNF-α and IFN-ɣ were reduced and improvement in PA.